Provider Demographics
NPI:1083040596
Name:UKANIDENTALGROUP
Entity Type:Organization
Organization Name:UKANIDENTALGROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GULABRAI
Authorized Official - Middle Name:B
Authorized Official - Last Name:UKANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-340-1144
Mailing Address - Street 1:1540 HAMNER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2914
Mailing Address - Country:US
Mailing Address - Phone:951-340-1144
Mailing Address - Fax:
Practice Address - Street 1:1540 HAMNER AVE STE 102
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2914
Practice Address - Country:US
Practice Address - Phone:951-340-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GULABRAI B UKANI DDS,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA340061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty